title: The psychological impact of a cancer diagnosed during pregnancy: determinants of long-term distress.
abstract: BACKGROUND
  Cancer occurs during one in 1000-5000 of the approximately 6 million yearly US pregnancies identified by the American Pregnancy Association. Although a newly diagnosed cancer is associated with substantial distress, little is known about cancer's emotional impact on women when diagnosed during pregnancy, and no studies have been conducted on the subject.
  
  
  OBJECTIVE
  The Cancer and Pregnancy Registry was developed by Elyce H. Cardonick MD, specialist in Maternal and Fetal Medicine and Associate Professor of Obstetrics and Gynecology at Robert Wood Johnson Medical School, to examine the consequences of maternal cancer diagnosis and treatment during pregnancy on maternal, fetal, and neonatal outcomes, including the impact of in utero exposure to chemotherapy.
  
  
  METHODS
  Participants were asked to complete questionnaires, including measures of psychological distress, permitting the examination of variables associated with long-term psychological distress in women following a cancer diagnosis in pregnancy.
  
  
  RESULTS
  Seventy-four women completed the Brief Symptom Inventory-18 and Impact of Event Scale on average 3.8 years (SD 2.5) following their cancer diagnosis. Potential variables related to distress included information on: sociodemographics, disease, pregnancy, birth, cancer treatment, and health status. Multiple regression analyses revealed that women were at higher risk of long-term distress if they had not received fertility assistance, had been advised to terminate the pregnancy, had had a preterm baby, had had a cesarean delivery, had not produced sufficient milk to breastfeed, had been experiencing a recurrence, and/or had undergone surgery post-pregnancy.
  
  
  CONCLUSIONS
  Results are discussed in light of our current knowledge of the normal developmental phase of pregnancy and motherhood.
authors.affiliation: McGill University, Montreal, Quebec, Canada. melissa.henry@mcgill.ca
authors.forename: Melissa
authors.initials: M
authors.lastname: Henry
authors.forename: Lina N
authors.initials: LN
authors.lastname: Huang
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Sproule
authors.forename: Elyce H
authors.initials: EH
authors.lastname: Cardonick
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D009369:Neoplasms / Q000523:psychology*; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000523:psychology*; D011256:Pregnancy Outcome / Q000523:psychology*; D012042:Registries; D013315:Stress, Psychological